Skin cancer is one of the most preventable types of cancers in the United States. Exposure to ultraviolet (UV) rays from outdoor sun exposure and tanning beds is the leading risk factor for the development of skin cancers. Genetics also play a role in the development of skin cancer, especially on the non sun-exposed areas of the body in all skin types. Each year, there are millions of reported cases of skin cancer in the United States. According to the American Academy of Dermatology, one in five Americans will develop skin cancer in their lifetime. The Skin Cancer Foundation recommends annual skin cancer screenings. While basal cell carcinomas (BCCs) usually remain localized, squamous cell carcinomas (SCCs), especially on the head and neck, have the capacity to spread to other localized areas over time. Melanomas, especially if left undiagnosed and untreated, have the capacity to spread to other organs and can be fatal. Patients with a prior history of melanoma are advised to have skin cancer screenings every three to six months while patients with BCCs or SCCs are recommended to have skin cancer screenings every six months within the first five years of diagnosis, as there is an increased risk of subsequent skin cancers after the initial diagnosis.
Actinic keratosis – Actinic keratosis are rough, pink lesions with yellow-white scale found on sun-damaged areas such as the face, arms, hands, upper chest and back, and legs. These lesions, if left untreated, can evolve into skin cancers. Treatment of actinic keratosis includes in-office liquid nitrogen treatments and the use of creams that remove sun-damage, such as 5-fluorouracil and imiquimod. Other treatment options offered outside of New Bloom Dermatology include photodynamic therapy.
Basal Cell Carcinoma – Basal cell carcinoma is the most common type of skin cancer that arises from sun-damaged skin. The appearance can range from a pearly, pink bump with rolled borders, a depressed scar, to a non-healing ulcer. Superficial lesions on the body can be treated by electrodessication and cautery while deeper lesions can be treated by surgical excision. Basal cell carcinomas on the scalp, face, and hands are best treated by Mohs’ surgery, done by a specialist outside of New Bloom Dermatology.
Melanoma – Melanoma represents one of the most lethal skin cancers if left undiagnosed or untreated, as it can spread to the rest of the body. This type of skin cancer arises from melanocytes or pigmented cells. Most lesions appear as a dark brown color, but can also be pink-red as well. It can appear anywhere on the body, including the palms and soles. While many cases involve sun-damaged skin, patients may also have a genetic predisposition to this condition. Treatment is done by a melanoma specialist outside of New Bloom Dermatology, which includes removal of the lesion and proper staging of the lesion. Advanced stages of melanoma often require further studies and other treatments including immunotherapy.
Squamous Cell Carcinoma – This type of skin cancer appears as pink or red patches or scaly flesh colored to pink-red plaques on sun-damaged skin. These lesions are usually located on the scalp, face, arms, legs, and hands. Superficial lesions on the body can be treated by electrodessication and cautery while deeper lesions can be treated by surgical excision. Squamous cell carcinomas on the scalp, face, and hands are best treated by Mohs’ surgery, done by a specialist outside of New Bloom Dermatology.
During the skin cancer screening at New Bloom Dermatology, a board certified dermatologist will review your medical history, prior history of sunburns and tanning booth use, and family history of skin cancer. Patients are checked from head to toe for any concerning lesions. A dermatoscope will be used to help magnify these areas for better visualization. If any moles or growths are suspicious for skin cancer, the dermatologist will recommend a skin biopsy for further examination. The risk of any skin biopsy includes bleeding, infection, scarring, and recurrence of the lesion. The skin sample is sent to the pathology lab and the results are issued within ten to fourteen days. The dermatologist will then review the results and discuss treatment options.
Additional preventative strategies include skin self-examinations and the use of sunscreens and sun protective clothing. Monthly skin self-examinations are recommended, as more than half of melanomas are detected by these exams, especially in the earlier stages. Patients are recommended to follow the ABCDE’s of melanoma, which stand for asymmetry, border irregularity, color variation, diameter greater than six millimeters, and evolving shape, color, and size. Another recommendation to follow during the skin self-examination is the ugly duckling sign, which emphasizes the tracking of moles that differ in color, shape, and size from the majority of other moles.
Daily use of a broad spectrum, water resistant sunscreen with a sun protection factor (SPF) of 30 or higher is recommended to be applied 15 minutes before sun exposure. The sunscreen should be reapplied to all sun exposed areas every one to two hours. Mineral or physical sunscreens consisting of zinc or titanium oxide are recommended, as they protect the skin from UVA, UVB, and visible light.
Hats and clothes can help absorb or block UV radiation. The ability of hats and clothing to block the sun from the skin is measured by ultraviolet protection factor (UPF). A UPF factor of 30 will allow only 1/30 of UV radiation to penetrate the fabric and consequently block 97% of the UV radiation from the skin. A UPF factor of 30 or higher is recommended by the Skin Cancer Foundation. Wide brimmed hats can help protect the ears and neck from sun exposure. They are especially recommended for patients with hair loss, as the scalp is a frequent site of UV exposure and skin cancers.
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